Unacceptable failure of osteochondral glenoid allograft for biologic resurfacing of the glenoid

Abstract Purpose Glenohumeral osteoarthritis (OA) represents a challenging problem in young, physically active patients. It was the purpose of this investigation to evaluate the results of a pilot study involving glenoid resurfacing with a glenoid allograft combined with a hemiarthroplasty on the hu...

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Autores principales:	Filippo Familiari, Bettina Hochreiter, Christian Gerber
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Shoulder osteoarthritis young patients osteochondral glenoid allograft biologic resurfacing failure rate Constant and Murley score Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/b6e13411b68c4168816b377e04cd8907
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spelling	oai:doaj.org-article:b6e13411b68c4168816b377e04cd89072021-12-05T12:17:39ZUnacceptable failure of osteochondral glenoid allograft for biologic resurfacing of the glenoid10.1186/s40634-021-00419-x2197-1153https://doaj.org/article/b6e13411b68c4168816b377e04cd89072021-12-01T00:00:00Zhttps://doi.org/10.1186/s40634-021-00419-xhttps://doaj.org/toc/2197-1153Abstract Purpose Glenohumeral osteoarthritis (OA) represents a challenging problem in young, physically active patients. It was the purpose of this investigation to evaluate the results of a pilot study involving glenoid resurfacing with a glenoid allograft combined with a hemiarthroplasty on the humeral side. Methods Between April 2011 to November 2013, 5 patients (3 men, 2 women, mean age 46.4, range 35-57) with advanced OA of the glenohumeral joint, were treated with a humeral head replacement combined with replacement of the glenoid surface with an osteochondral, glenoid allograft. Results Overall, clinically, there was one excellent, one satisfactory and three poor results. Mean preoperative subjective shoulder value (SSV) was 34% (range: 20-50%) and preoperative relative Constant-Murley-Score (CSr) was 43 points (range: 29-64 points). Three patients with poor results had to be revised within the first three years. Their mean pre-revision SSV and CSr were 38% (range: 15-80%) and 36 points (range: 7-59 points) respectively. One patient was revised 9 years after the primary procedure with advanced glenoid erosion and pain and one patient has an ongoing satisfactory outcome without revision. Their SSVs were 60% and 83%, their CSr were 65 points and 91 points, 9 and 10 years after the primary procedure, respectively. Mean follow-up was 7 years (2-10 years) and mean time to revision was 4 years (range: 1-9 years). Conclusion The in-vivo pilot study of a previously established in-vitro technique of osteochondral glenoid allograft combined with humeral HA led to three early failures and only one really satisfactory clinical outcome which, however, was associated with advanced glenoid erosion. Osteochondral allograft glenoid resurfacing was associated with an unacceptable early failure rate and no results superior to those widely documented for HA or TSA, so that the procedure has been abandoned. Level of evidence Level IV, Case Series, Treatment Study.Filippo FamiliariBettina HochreiterChristian GerberSpringerOpenarticleShoulder osteoarthritisyoung patientsosteochondral glenoid allograftbiologic resurfacingfailure rateConstant and Murley scoreOrthopedic surgeryRD701-811ENJournal of Experimental Orthopaedics, Vol 8, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Shoulder osteoarthritis young patients osteochondral glenoid allograft biologic resurfacing failure rate Constant and Murley score Orthopedic surgery RD701-811
spellingShingle	Shoulder osteoarthritis young patients osteochondral glenoid allograft biologic resurfacing failure rate Constant and Murley score Orthopedic surgery RD701-811 Filippo Familiari Bettina Hochreiter Christian Gerber Unacceptable failure of osteochondral glenoid allograft for biologic resurfacing of the glenoid
description	Abstract Purpose Glenohumeral osteoarthritis (OA) represents a challenging problem in young, physically active patients. It was the purpose of this investigation to evaluate the results of a pilot study involving glenoid resurfacing with a glenoid allograft combined with a hemiarthroplasty on the humeral side. Methods Between April 2011 to November 2013, 5 patients (3 men, 2 women, mean age 46.4, range 35-57) with advanced OA of the glenohumeral joint, were treated with a humeral head replacement combined with replacement of the glenoid surface with an osteochondral, glenoid allograft. Results Overall, clinically, there was one excellent, one satisfactory and three poor results. Mean preoperative subjective shoulder value (SSV) was 34% (range: 20-50%) and preoperative relative Constant-Murley-Score (CSr) was 43 points (range: 29-64 points). Three patients with poor results had to be revised within the first three years. Their mean pre-revision SSV and CSr were 38% (range: 15-80%) and 36 points (range: 7-59 points) respectively. One patient was revised 9 years after the primary procedure with advanced glenoid erosion and pain and one patient has an ongoing satisfactory outcome without revision. Their SSVs were 60% and 83%, their CSr were 65 points and 91 points, 9 and 10 years after the primary procedure, respectively. Mean follow-up was 7 years (2-10 years) and mean time to revision was 4 years (range: 1-9 years). Conclusion The in-vivo pilot study of a previously established in-vitro technique of osteochondral glenoid allograft combined with humeral HA led to three early failures and only one really satisfactory clinical outcome which, however, was associated with advanced glenoid erosion. Osteochondral allograft glenoid resurfacing was associated with an unacceptable early failure rate and no results superior to those widely documented for HA or TSA, so that the procedure has been abandoned. Level of evidence Level IV, Case Series, Treatment Study.
format	article
author	Filippo Familiari Bettina Hochreiter Christian Gerber
author_facet	Filippo Familiari Bettina Hochreiter Christian Gerber
author_sort	Filippo Familiari
title	Unacceptable failure of osteochondral glenoid allograft for biologic resurfacing of the glenoid
title_short	Unacceptable failure of osteochondral glenoid allograft for biologic resurfacing of the glenoid
title_full	Unacceptable failure of osteochondral glenoid allograft for biologic resurfacing of the glenoid
title_fullStr	Unacceptable failure of osteochondral glenoid allograft for biologic resurfacing of the glenoid
title_full_unstemmed	Unacceptable failure of osteochondral glenoid allograft for biologic resurfacing of the glenoid
title_sort	unacceptable failure of osteochondral glenoid allograft for biologic resurfacing of the glenoid
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/b6e13411b68c4168816b377e04cd8907
work_keys_str_mv	AT filippofamiliari unacceptablefailureofosteochondralglenoidallograftforbiologicresurfacingoftheglenoid AT bettinahochreiter unacceptablefailureofosteochondralglenoidallograftforbiologicresurfacingoftheglenoid AT christiangerber unacceptablefailureofosteochondralglenoidallograftforbiologicresurfacingoftheglenoid
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Unacceptable failure of osteochondral glenoid allograft for biologic resurfacing of the glenoid

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